Faith Based Counseling: Culturally Competent or Unethical?

Treatment plan for client with mild depression and anxiety symptoms.

Short term goals: Instill hope for the future. Identify maladaptive beliefs that exacerbate depression and anxiety symptoms. Replace maladaptive beliefs with more true beliefs. Client will be able to practice emotional management skills inside and outside of times of stress. Client will expand support network and reach out for support more frequently.

Interventions: Cognitive behavioral therapy including bibliotherapy, journaling, affirmation work, and practicing forms of meditation in and out of session. Encourage and support pro-community behaviors and reaching out to support networks.

Notice this is a super simplistic example of a very brief treatment plan. Notice the interventions. Anything feel out of the ordinary? Maybe this isn't your particular treatment plan or style... but there isn't anything that would make me pause as a clinical supervisor.

Now... let's try those interventions again...

Interventions: Christian Based CBT including bible reading, journaling, biblical verse work, and practicing forms of prayer in and out of session. Encourage and support church attendance and reaching out to clergy and church friends.

I know a lot of therapists who would go through the roof it they read those interventions and many for very valid reasons. I don't think there is a therapist of any faith who hasn't seen someone harmed by religion, well meaning religious people, or not so well meaning people using religion harmfully.

But pause for a moment... taking each section line by line... are these interventions so different? Does infusing the same well-researched interventions with a particular religious theme make those interventions ineffective?

Does clearly stating a treatment plan inside of a faith or religious context mean a therapist has lost their way? Is forcing their worldview on a client who could be harmed?

Or.. is the therapist being culturally competent? Are they using words and interventions that resonate with the client's worldview, preferences, and that help the client feel safe in the therapy room?

Here is the truth: I have seen clients hurt, a LOT. There are great therapists that practice ethically and integrate faith. There are terrible therapists that practice unethically and integrate faith. There are therapists great and terrible that are integrating faith and don't even realize it. There are therapists great and terrible that try to ban faith from the therapy room and end up banning an entire part of clients. The list goes on and on...

A lot of therapists are unsure about how, when, why, and where to integrate faith into the therapy room. And they are confused about whether it is ok to integrate faith into their private practice... Over the next several weeks we are going to be sharing some different perspectives on integrating faith into private practices.

What are your questions? What are your fears? What are your hopes for this series? Share in the comments below- we truly want to hear from you and answer your burning questions.

I have successfully built a cash pay psychotherapy practice from scratch on
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have the licensing board send me a later months later saying I passed),
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I've failed at launching online programs. I've had wild success at
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taught others how to avoid my mistakes. You can do this. You were called to
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